Method for installing individualized bracket system using brackets with standard prescriptions and kit for its implementation

Abstract

FIELD: orthodontics.SUBSTANCE: intended for use in installing a bracket system on a patient's teeth in an indirect manner. Virtual 3D orthodontic treatment planning is performed, during which the calculated position of each standard bracket on the tooth surface and the geometry of the compensating attachment are determined, ensuring that the standard bracket is aligned with the calculated values of the individualized prescription. Based on the virtual planning data, the first mouth guard is made, on the inner surface of which cavities are formed for placing compensating attachments. Compensating attachments are manufactured with pre-calculated geometric parameters. Compensating attachments are placed in the corresponding cavities of the first splint. Compensating attachments are fixed on the patient's teeth by applying photopolymerizable orthodontic glue to the patient's teeth or to the compensating attachments placed in the cavities of the first splint, placing the first splint on the dental arch and performing photopolymerization. Then the first splint is removed. A second splint is made based on the virtual planning data. In this case, the second splint is designed with the ability to hold standard braces in their calculated position with an indentation from the inner surface of the splint equal to the size of the corresponding compensating attachment. Indirect fixation of standard braces is carried out using a second splint by placing it on the dental row with already fixed compensating attachments, ensuring the adhesion of the bases of the braces to the surfaces of the compensating attachments, followed by photopolymerization of the orthodontic adhesive.EFFECT: inventions, due to the precise correspondence of the actual position of each standard bracket to its individualized calculated position on the corresponding patient tooth, specified during virtual planning, allow for increased accuracy in the implementation of the specified bracket prescription and a reduction in treatment time.7 cl, 5 dwg

Description

[0001] The invention relates to the field of medicine, in particular to dentistry, or more precisely to orthodontics, and can be used to install a bracket system on a patient's teeth using standard brackets.

[0002] When performing orthodontic treatment using braces, it is important that the geometric parameters of the braces correspond to the patient's anatomical features. This is always possible with fully custom-made braces and is partially possible in some clinical cases with standard braces.

[0003] In this description, the term “standard bracket” will be used to refer to brackets made using so-called standard prescriptions.

[0004] The standard prescription of braces in orthodontics refers to the values ​​of torque (inclination) - the angular characteristic of the vestibulo-oral position of the tooth, angulation - the angular characteristic of the mesiodistal position of the tooth, in-out (offset) - the linear characteristic of the position of the tooth in the dental arch in the vestibulo-oral direction, rotation - the angular characteristic of the rotation of the tooth around the vertical axis.

[0005] At the same time, torque affects the inclination of the tooth and the stable position of the root in the bone tissue after treatment, angulation affects the correct contacts of the teeth with the antagonists, the aesthetics of the smile and the perception of vertical and horizontal loads, in-out affects the shape of the dentition, and the relief of the base of the bracket affects the ease of fixation and, as a result, the accuracy of the above parameters.

[0006] The existing versions of brackets made with standard prescriptions are proprietary developments that determine the final position of each tooth when using the Straight Wire technique, such as the Andrews Straight-Wire Appliance, the Roth Prescription, and the MBT System (McLaughlin, Bennett, Trevisi).

[0007] At the same time, the prescriptions for standard braces are developed based on the neutral position of the patient's jaws in three planes of space, as well as the only possible final "normal" position of the teeth, described as "correct bite".

[0008] Any deviations in the position or size of the jaw bones inherent in each patient do not fit into the parameters of the generally accepted standard norm.

[0009] It should also be noted that the specified torque, angulation, in-out, and rotation characteristics directly depend on the accuracy of standard bracket positioning in accordance with the recommendations established by the bracket system manufacturer and the prescription author. Any deviation from the recommended fixation point unpredictably alters the prescription characteristics of standard brackets due to the individual curvature of the buccal surface of the tooth.

[0010] Individualization of standard braces allows you to achieve the planned position of the tooth with the existing size and position of the jaw bones, significantly expanding the possibilities of conservative orthodontic treatment without the use of orthognathic surgery and / or devices that modify the growth and position of the jaw bones, thereby allowing you to achieve an individual, functionally and aesthetically acceptable position of the teeth in the dentition, as well as their correct relationship.

[0011] If the bracket parameters do not correspond to the patient's anatomical features, the treatment period may increase, and working with such a bracket system will require high qualifications from the doctor.

[0012] Quality and rapid treatment with braces is only possible when the braces' parameters fully match the patient's anatomical features. This approach is possible with virtual treatment planning (moving 3D dental models onto 3D bone models) to determine the required prescription parameters.

[0013] Based on virtual treatment planning, custom-made braces can be manufactured. Their parameters are fully tailored to the patient's anatomical features, helping to speed up treatment and achieve stable results.

[0014] However, the production of customized braces takes a long time and the cost of their production is significantly higher than the cost of producing standard braces.

[0015] The problem of accurately placing brackets in the intended location on the tooth can be partially resolved by using indirect bracket fixation using standard brackets and a transfer tray. This method allows for the most precise placement of brackets on the tooth. However, it does not allow for customization of the standard bracket prescription parameters to the individual needs of the patient.

[0016] The problem of using standard braces taking into account the individualization of prescription parameters for an individual patient is solved by the device and method described in patent CN 113100978 (prior. 03 / 23 / 2021) "Device for fastening braces with bracket compensation and a positioning unit and a method for designing it", which is closest to the claimed device in technical essence and the achieved result, and is selected as a prototype.

[0017] The patent describes a method for fixing brackets and a device for implementing it, designed as a positioning sleeve with a mounting cavity and a compensating positioning module (attachment) located within the mounting cavity. The compensating positioning attachment is removable within the positioning sleeve. One side of the compensating positioning attachment is used for fixation to the tooth surface, and the other side is used for positioning or adhering a standard bracket.

[0018] A compensating attachment made of light-cured resin and a standard bracket are placed into each cavity of the positioning sleeve, forming a block. The sleeve is placed on the tooth, and the block is pressed against the tooth surface. The block is light-cured and bonded to the tooth. The sleeve is removed. The compensating block remains on the tooth with the standard bracket bonded to it.

[0019] The compensating block thus acts as a customized "adapter" or "foundation" that compensates for the difference between the smooth base of a standard bracket and the complex contours of the tooth. This allows the use of inexpensive standard brackets instead of expensive custom-made ones.

[0020] The main drawback is the difficulty and instability of installing the positioning sleeves individually on each tooth. Each individually installed bracket can shift relative to one another, both in angle and distance, which can introduce errors in achieving the final orthodontic treatment result.

[0021] The problem that the invention is aimed at solving is to create a method of orthodontic treatment that is free from the aforementioned drawbacks, namely, one that ensures and guarantees the individualization of standard braces during the installation process, while simultaneously guaranteeing their placement on the patient’s teeth in accordance with the proposed treatment plan, which makes it possible to reduce the treatment time, achieve a stable result, reduce the cost of treatment and simplify the work of the orthodontist.

[0022] The technical result is to ensure that the actual position of each standard bracket precisely corresponds to its calculated position on the corresponding patient's tooth, specified during virtual planning.

[0023] The stated problem is solved, and the technical result is achieved, by using the method proposed in this invention for installing a customized bracket system using brackets with standard prescriptions. Virtual 3D orthodontic treatment planning is performed. During this planning, the calculated position of each standard bracket on the tooth surface and the geometry of the compensating attachment are determined, ensuring the standard bracket conforms to the calculated values ​​of the customized prescription. Based on the virtual planning data, a first aligner is fabricated, with cavities formed on the inner surface for accommodating the compensating attachments. Compensating attachments are manufactured with pre-calculated geometric parameters and placed in the corresponding cavities of the first aligner.Compensating attachments are secured to the patient's teeth by applying light-curing orthodontic adhesive to the patient's teeth or to the compensating attachments placed in the cavities of the first tray, placing the first tray on the dentition, and allowing it to light-cured. The first tray is then removed. A second tray is fabricated based on the virtual planning data. The second tray is designed to hold standard brackets in their intended position with an offset from the inner surface of the tray equal to the size of the corresponding compensating attachment. Indirect fixation of standard brackets is achieved using the second tray by placing it on the dentition with the compensating attachments already secured, ensuring the bases of the brackets adhere to the surfaces of the compensating attachments, followed by light-curing the orthodontic adhesive.

[0024] It is preferable to manufacture the first and second mouth guards using an additive method.

[0025] It is also preferable to manufacture compensating attachments by additive manufacturing.

[0026] It should be understood that the geometry of the compensating attachment corrects at least one of the following prescription parameters - torque, angulation, in-out.

[0027] The stated problem is also solved, and the technical result is achieved, by providing a kit for implementing the method for individualizing standard brackets, including a set of standard brackets. It comprises a first mouthguard, designed with cavities for retaining compensating attachments during their fixation to the tooth surface, a set of compensating attachments manufactured based on virtual 3D orthodontic treatment planning, and a second mouthguard, designed to hold the standard brackets in a position that ensures their fixation to said compensating attachments. Each bracket is secured in the second mouthguard with an indentation from the inner surface corresponding to the compensating attachment.

[0028] Also, the first and second mouth guards included in the kit for implementing the method described in the invention can be made from a photopolymer material using the 3D printing method.

[0029] It is also possible to produce compensation attachments from photopolymer material using 3D printing.

[0030] Conducting virtual 3D planning of orthodontic treatment, during which the calculated position of each standard bracket on the surface of the corresponding tooth and the geometry of the compensating attachment are determined, ensuring that the standard bracket is brought to the specified individualized calculated values ​​of the patient's prescription, allows us to obtain the necessary data for the manufacture of the first cap, on the inner surface of which cavities are formed for placing compensating attachments in them, and to manufacture it.

[0031] Also, the data obtained as a result of virtual 3D planning of orthodontic treatment allows for the production of compensating attachments with pre-calculated geometric parameters.

[0032] Further placement of compensating attachments in the corresponding cavities of the first cap, their fixation on the patient's teeth by applying photopolymerizable orthodontic glue to the patient's teeth or to the compensating attachments placed in the cavities of the first cap and applying the first cap to the dentition with photopolymerization, allows for the precise installation of compensating attachments in places previously planned as a result of virtual 3D planning of orthodontic treatment.

[0033] After removing the first cap, the areas are prepared for the installation of standard braces.

[0034] The production of a second cap based on virtual planning data with the ability to hold standard brackets in their calculated position with an indentation from the inner surface of the cap equal to the size of the corresponding compensating attachment allows the use of standard brackets for a specific individual patient.

[0035] Indirect fixation of standard braces, which is carried out using a second cap by placing it on the dentition with already fixed compensating attachments, followed by photopolymerization of orthodontic glue, ensures the adhesion of the bases of the standard braces to the surfaces of the compensating attachments and guarantees the installation of standard braces in pre-calculated positions during virtual 3D planning.

[0036] The production of the first and second mouth guards by an additive method using a 3D printer makes it possible to produce mouth guards with an accuracy sufficient for their use in the method proposed in the invention.

[0037] The preferred additive manufacturing of the compensating attachments using 3D printing ensures that the compensating attachments are produced with sufficient accuracy for their use in the method proposed in the invention.

[0038] The fact that the geometry of each attachment corrects at least one of the following prescription parameters, such as torque, angulation or in-out, makes it possible to solve the problem posed to the invention, to ensure and guarantee the individualization of standard brackets.

[0039] The fact that the kit for implementing the method includes a set of standard braces, and also contains a first cap made with cavities for holding compensating attachments when they are fixed on the surface of the teeth, a set of compensating attachments made on the basis of virtual 3D planning of orthodontic treatment, and a second cap made with the possibility of holding standard braces in a position that ensures their fixation on the said compensating attachments, makes it possible to consistently perform all the necessary operations for installing an individualized bracket system for a patient using brackets with standard prescriptions.

[0040] Fixing standard brackets in a second cap with an indentation from the inner surface corresponding to the compensating attachment allows for precise fixation of the specified brackets on the compensating attachment corresponding to each bracket and already fixed on the tooth.

[0041] The use of the first and second caps in the set, made of photopolymer material using 3D printing, ensures the accuracy of the placement of compensating attachments on the patient's teeth, and standard braces on the specified compensating attachments.

[0042] Also, the use of compensating attachments made from photopolymer material using 3D printing ensures the accuracy of orthodontic treatment.

[0043] Thus, all the features given in the formula of the invention are aimed at achieving a technical result, namely, ensuring precise correspondence between the actual position of the standard bracket on the tooth and its calculated position specified during virtual planning, due to the formation of a compensating attachment, individually calculated using virtual 3D planning for each tooth, and the precise installation of each standard bracket in a pre-planned position on the compensating attachment.

[0044] The claimed invention is further explained by a detailed description of a specific, but not limiting, example of its implementation and the accompanying drawings, in which:

[0045] Fig. 1 - shows a variant of the first cap with formed cavities for retaining compensating attachments;

[0046] Fig. 2 - shows compensating attachments fixed on the patient's teeth, placed using the first cap;

[0047] Fig. 3 - shows a version of the second cap for indirect fixation of standard braces;

[0048] Fig. 4 - shows standard braces fixed on compensating attachments;

[0049] Fig. 5 - shows standard brackets fixed on compensating attachments, occlusal view.

[0050] The method for installing an individualized bracket system using brackets with standard prescriptions, proposed in the present invention, is based on the use of a kit for its implementation, including: a set of standard brackets 1, as well as two caps and a set of compensating attachments 3.

[0051] It should be noted that the type of prescription of standard brackets 1 is not of fundamental importance and affects only the corrections made due to the shape of the compensating attachment 3.

[0052] The first cap 2 is designed with the possibility of holding compensating attachments 3 in it for their installation on the surface of teeth 4, as shown in Fig. 1.

[0053] The second cap 5 for indirect fixation is designed with the possibility of holding standard braces 1 in the calculated position with a given indentation from the surface of the teeth 4 for installing standard braces 1 on already fixed compensating attachments 3, as shown in Fig. 3.

[0054] The method includes, at the first stage, conducting virtual 3D planning of orthodontic treatment, during which the required prescription parameters (torque, angulation, in-out) and the calculated position of each standard bracket 1 on the surface of tooth 4 are determined to move teeth 4 to a given position.

[0055] At this stage, a 3D scan of the patient's dentition is performed, creating a virtual model. Using specialized software, such as 3Shape or exocad, the orthodontist performs a virtual placement of the teeth into their ideal position (called a digital setup).

[0056] Next, 3D models of standard brackets 1 are placed on the virtual models of teeth 4 in their initial positions. For each standard bracket 1, a position is calculated on the corresponding tooth 4 that will ensure movement of tooth 4 to the specified point in the specified position. This identifies the discrepancy between the base geometry of standard bracket 1 and the surface geometry of tooth 4. This discrepancy is the volume that must be filled by compensating attachment 3.

[0057] The next step of the method proposed in the invention involves manufacturing the first mouth guard 2. The first mouth guard 2 is manufactured based on virtual 3D planning data, for example, using additive 3D printing. Preferably, a transparent photopolymer, such as Dental SG or an equivalent, is used to manufacture the first mouth guard 2.

[0058] On the inner surface of the first cap 2, corresponding to the surface of the teeth 4, cavities are formed, the shape and location of which allows compensating attachments 3 to be placed in them and held until fixed on the teeth.

[0059] Compensating attachments 3, as mentioned above, are designed to compensate for the discrepancy between the relief of the base of the standard bracket 1 and the relief of the surface of the tooth 4, while they provide the required prescription parameters, such as torque, angulation, in-out.

[0060] Compensating attachments 3 are preferably manufactured using the additive 3D printing method, which allows for achieving the most accurate orthodontic treatment result.

[0061] Then, based on the virtual planning data, a second cap 5 is manufactured for indirect fixation of standard brackets 1. In the second cap 5 for indirect fixation, standard brackets 1 are installed and fixed in the calculated positions with an indentation from the inner surface of the second cap 5 equal to the indentation of the outer surface of the compensating attachment 3 from the corresponding teeth 4.

[0062] The second cap 5 for indirect fixation is also preferably manufactured additively, for example by 3D printing, which makes it possible to obtain an accurate positioner for standard braces 1.

[0063] To perform the work of installing standard braces 1 with individualization for a specific patient, the orthodontist uses the kit proposed in the present invention and, at the first stage, prepares the teeth 4 for fixing the compensating attachments 3 using the standard method.

[0064] The dentist places the first mouth guard 2 on teeth 4, with compensating attachments 3 pre-inserted into the cavities. He applies orthodontic adhesive either to the tooth surfaces or to the compensating attachments themselves. He then illuminates the adhesive with a polarizing dental light. After removing the first mouth guard 2, compensating attachments 3 remain on teeth 4, filling the space between the surface of tooth 4 and the mounting pad for standard bracket 1 of the corresponding tooth 4, as shown in Fig. 2. The size of compensating attachment 3 fully corresponds to the size of the base of the standard bracket 1 being installed.

[0065] Then, after removing the first cap 2, the doctor applies orthodontic glue to the base of the brackets 1 or to the surface of the compensating attachments 3 installed on the teeth. After that, the doctor applies the second cap 5 for indirect fixation with standard brackets 1 on the dentition, ensuring a perfect fit of the bases of the standard brackets 1 to the surfaces of the compensating attachments 3. This facilitates precise individualization of the prescription of the standard bracket 1 and the movement of the tooth 4 to the calculated position.

[0066] To fix standard braces 1 on the surface of compensating attachments 3, the doctor performs photopolymerization.

[0067] After fixing the standard braces 1, the doctor removes the second cap 5, leaving the standard braces 1 fixed on the compensating attachments 3, as shown in Figs. 4 and 5.

[0068] Thus, in a clinical setting, the dentist sequentially uses the first tray 2, then the second tray 5 for indirect bonding, as described above. As a result, standard bracket 1 is bonded not directly to tooth 4, but to a custom-designed compensating attachment 3, ensuring the precise implementation of the planned parameters of the individual prescription.

[0069] The novelty of the treatment method proposed by the authors lies in its hybrid approach, which utilizes digital planning and additive technologies. This allows for the use of existing, mass-produced, and affordable standard brace systems, making high-precision orthodontic treatment more affordable and faster to implement than custom-made braces.

[0070] Thus, the method proposed in the invention for installing an individualized bracket system using brackets with standard prescriptions and a kit for implementing it makes it possible to achieve a technical result and ensure precise correspondence between the actual position of the standard bracket 1 on the tooth 4 and its calculated position specified during virtual planning, due to the formation of a compensating attachment 3, individually selected for each tooth 4, and the precise installation of each standard bracket 1 in a pre-planned position on the attachment 3.

[0071] This achieves a solution to the problem, namely, to ensure and guarantee the individualization of the parameters of the prescription of standard braces, which allows for a reduction in treatment time, achieving stable results, reducing the cost of treatment and simplifying the work of the orthodontist.

Claims

1. A method for installing an individualized bracket system using brackets with standard prescriptions, during which the calculated position of each standard bracket on the tooth surface and the geometry of the compensating attachment are determined, ensuring that the standard bracket is brought to the calculated values ​​of the individualized prescription, characterized in that a first cap is manufactured on the basis of virtual planning data, on the inner surface of which cavities are formed for placing compensating attachments in them, compensating attachments are manufactured with pre-calculated geometric parameters, compensating attachments are placed in the corresponding cavities of the first cap, compensating attachments are fixed on the patient's teeth by applying photopolymerizable orthodontic adhesive to the patient's teeth or to compensating attachments placed in the cavities of the first cap, placing the first cap on the dentition and performing photopolymerization,then the first cap is removed, a second cap is made based on the virtual planning data, wherein the second cap is designed with the ability to hold the standard brackets in their calculated position with an indentation from the inner surface of the cap equal to the size of the corresponding compensating attachment, indirect fixation of the standard brackets is carried out using the second cap by placing it on the dentition with already fixed compensating attachments, ensuring the adhesion of the bases of the brackets to the surfaces of the compensating attachments, with subsequent photopolymerization of the orthodontic adhesive.

2. The method according to paragraph 1, characterized in that the first and second caps are manufactured using an additive method.

3. The method according to paragraph 1, characterized in that the compensating attachments are manufactured using an additive method.

4. The method according to claim 1, characterized in that the geometry of the compensating attachment corrects at least one of the following prescription parameters: torque, angulation, in-out.

5. A kit for implementing the method according to any one of paragraphs 1-4, including a set of standard braces, characterized in that it contains a first cap made with cavities for holding compensating attachments when they are fixed on the surface of the teeth, a set of compensating attachments manufactured on the basis of virtual 3D planning of orthodontic treatment, and a second cap made with the possibility of holding the standard braces in a position that ensures their fixation on the said compensating attachments, wherein each bracket is fixed in the second cap with an indentation from the inner surface corresponding to the compensating attachment.

6. The kit according to item 5, characterized in that the first and second mouth guards are made of photopolymer material using 3D printing.

7. The kit according to paragraph 5, characterized in that the compensation attachments are made from photopolymer material using the 3D printing method.

Images